Preventing Impaired Driving

Key points

  • There are multiple known effective measures for preventing alcohol-impaired driving, including laws, enforcement, and technology.
  • Less is known about effective measures for the prevention of drug-impaired driving compared to alcohol-impaired driving, but there are promising strategies such as standardized toxicological testing of drivers.

State and community prevention

Effective measures for preventing alcohol-impaired driving include:

Laws and enforcement

  • Actively implementing and enforcing lower BAC limits.1
    • Globally, most high-income countries have BAC laws set at 0.05 g/dl or lower,23 and these laws are effective for reducing crashes involving alcohol-impaired drivers and deaths from these crashes.1 These laws serve as a general deterrent and reduce alcohol-impaired driving, even among drivers who are at highest risk of impaired driving.1
    • Utah implemented a 0.05 g/dL BAC law in 2018; the other 49 states and the District of Columbia (DC) have a BAC limit of 0.08 g/dL.45 Utah's 0.05 g/dL BAC law was associated with an 18% reduction in the motor vehicle crash death rate per mile driven in the first year after it went into effect. The new law was also associated with lower alcohol involvement in crashes.4
    • An estimated 1,790 lives could be saved each year if all states adopted a 0.05 g/dl BAC limit.6
  • Maintaining minimum legal drinking age laws and zero tolerance laws for drivers younger than 21 in all states.178
  • Requiring alcohol ignition interlocks for all people convicted of alcohol-impaired driving, including first-time offenders.9 Additionally, incorporating alcohol use disorder assessment and treatment into interlock programs shows promise in reducing repeat offenses even after interlocks are removed.10
  • Implementing publicized sobriety checkpoints711 and high-visibility saturation patrols.7

Screening, assessment, and treatment

  • Screening, brief intervention, and referral to treatment can be beneficial for people who drink alcohol excessively but do not have alcohol use disorder. Brief interventions often involve assessing readiness, motivators, and barriers for behavior change. These types of interventions can also be delivered through technologies such as computers, cell phones, and tablets.11213
    • CDC's Alcohol Screening Tool can be used by adults to assess their drinking and create a personal change plan.
  • Implementing alcohol use disorder assessment and treatment, if needed, for people who are convicted of alcohol-impaired driving.17

Population-level strategies

  • Supporting affordable alternative transportation options, such as nighttime and weekend public transportation hours.1
  • Using strategies that increase the price of alcohol and make it less convenient to buy, such as increasing alcohol taxes and regulating alcohol outlet density. These strategies are effective for reducing drinking to impairment and also help to prevent alcohol-impaired driving.1141516
  • Implementing programs that combine prevention efforts (such as sobriety checkpoints and limiting access to alcohol) with the involvement of a community coalition or task force.17

Technology

  • The National Transportation Safety Board (NTSB) recommends that all new vehicles should be equipped with technology that prevents or limits the vehicle from operating if the driver is impaired by alcohol.18 The Bipartisan Infrastructure Law calls on the National Highway Traffic Safety Administration to issue a Federal Motor Vehicle Safety Standard requiring all new passenger vehicles to come equipped with advanced technology for the prevention of impaired driving.19 This technology has significant potential to reduce impaired driving fatalities.1

Keep Reading: What Works: Strategies to Reduce or Prevent Alcohol-Impaired Driving

Less is known about effective measures for the prevention of drug-impaired driving compared to alcohol-impaired driving.7

However, the following strategies are promising:

Enforcement of drug-impaired driving laws7

Standardized toxicological testing of drivers

  • Should include testing for both those stopped for suspicion of impaired driving and those involved in fatal crashes.2021
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Content Source:
National Center for Injury Prevention and Control
  1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Negussie Y, Geller A, Teutsch SM, editors. Washington, DC: National Academies Press(US); 2018.
  2. World Health Organization (WHO). Global status report on road safety 2018. Geneva, Switzerland: World Health Organization; 2018.
  3. Yellman MA, Sauber-Schatz EK. Motor Vehicle Crash Deaths — United States and 28 Other High-Income Countries, 2015 and 2019. MMWR Morb Mortal Wkly Rep. 2022;71(26):837–843. doi:10.15585/mmwr.mm7126a1
  4. Thomas FD, Blomberg R, Darrah J, Graham L, Southcott T, Dennert R, Taylor E, Treffers R, Tippetts S, McKnight S, Berning A. Evaluation of Utah's .05 BAC per se law (Report No. DOT HS 813 233). Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration; February 2022.
  5. Insurance Institute for Highway Safety (IIHS), Highway Loss Data Institute (HLDI). Alcohol and Drugs. Insurance Institute for Highway Safety, Highway Loss Data Institute; 2022.
  6. Fell JC, Scherer M. Estimation of the potential effectiveness of lowering the blood alcohol concentration (BAC) limit for driving from 0.08 to 0.05 grams per deciliter in the United States. Alcohol Clin Exp Res. 2017;41:2128–2139. doi:10.1111/add.12365
  7. Venkatraman V, Richard CM, Magee K, Johnson K. Countermeasures That Work: A Highway Safety Countermeasures Guide for State Highway Safety Offices, 10th Edition, 2020 (Report No. DOT HS 813 097) [PDF – 641 pages]. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA); July 2021.
  8. Guide to Community Preventive Services. CPSTF Findings for Motor Vehicle Injury: Reducing Alcohol-Impaired Driving. 2021.
  9. Guide to Community Preventive Services. Motor Vehicle Injury – Alcohol-Impaired Driving: Ignition Interlocks. 2021.
  10. Voas RB, Tippetts AS, Bergen G, Grosz M, Marques P. Mandating treatment based on interlock performance: evidence for effectiveness. Alcohol Clin Exp Res. 2016;40(9):1953–1960. doi:10.1111/acer.13149
  11. Guide to Community Preventive Services. Motor Vehicle Injury – Alcohol-Impaired Driving: Publicized Sobriety Checkpoint Programs. 2021.
  12. Tansil KA, Esser MB, Sandhu P, Reynolds JA, Elder RW, Williamson RS, Chattopadhyay SK, Bohm MK, Brewer RD, McKnight-Eily LR, Hungerford DW, Toomey TL, Hingson RW, Fielding JE; Community Preventive Services Task Force. Alcohol Electronic Screening and Brief Intervention: A Community Guide Systematic Review. Am J Prev Med. 2016;51(5):801–811. doi:10.1016/j.amepre.2016.04.013
  13. U.S. Preventive Services Task Force. Final Recommendation Statement – Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions. U.S. Preventive Services Task Force; November 2018.
  14. Centers for Disease Control and Prevention (CDC). Preventing Excessive Alcohol Use. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2022.
  15. Guide to Community Preventive Services. Alcohol – Excessive Consumption: Increasing Alcohol Taxes. 2021.
  16. Guide to Community Preventive Services. Alcohol – Excessive Use: Outlet Density. 2021.
  17. Shults RA, Elder RW, Nichols J, Sleet DA, Compton R, Chattopadhyay SK; Task Force on Community Preventive Services. Effectiveness of multicomponent programs with community mobilization for reducing alcohol-impaired driving. Am J Prev Med.2009;37(4):360–371. doi:10.1016/j.amepre.2009.07.005
  18. National Transportation Safety Board (NTSB). Safety Recommendation H-22-022. Washington, DC: National Transportation Safety Board. 2022.
  19. National Highway Traffic Safety Administration (NHTSA). Bipartisan Infrastructure Law. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration.
  20. D'Orazio AL, Mohr ALA, Chan-Hosokawa A, Harper C, Huestis MA, Limoges JF, Miles AK, Scarneo CE, Kerrigan S, Liddicoat LJ, Scott KS, Logan BK. Recommendations for Toxicological Investigation of Drug-Impaired Driving and Motor Vehicle Fatalities—2021 Update. J Anal Toxicol. 2021;45(6):529–536. doi:10.1093/jat/bkab064
  21. Azofeifa A, Rexach-Guzmán BD, Hagemeyer AN, Rudd RA, Sauber-Schatz EK. Driving Under the Influence of Marijuana and Illicit Drugs Among Persons Aged ≥16 Years — United States, 2018. MMWR Morb Mortal Wkly Rep. 2019;68(50):1153–1157.